We thank Dr. Azer for his comments on our Innovation Report. We wholeheartedly agree that community stakeholder engagement is ideal when revising teaching cases and applaud him for successfully incorporating such perspectives in his case revisions. With this aim, we had sought feedback about the structured guide from students of diverse minority groups and medical education leaders, some of whom also identified as underrepresented minorities. However, as we acknowledged in our Innovation Report, our final faculty–student workgroup was not fully representative.
In the second phase of our project, a new workgroup of 6 medical students who more fully represented minority identities provided concrete edits to Aquifer’s teaching cases using the structured guide. These edits have been incorporated, and feedback from the student workgroup, as well as unsolicited feedback from student users, have helped to affirm the guide’s utility and applicability in improving presentation of race and culture.
Although we emphasized the value of student engagement in this process within our paper, we also witnessed the meaningful dialogue and learning that resulted for both students and faculty within the Aquifer Consortium from discussing the guide and implementing case changes. As Dr. Azer notes, thoughtful case review can be a rich source of learning and faculty development, contributing to community building and understanding. We hope our guide, with its accompanying rationale and evidence base for suggested edits, can stimulate dialogue, learning, and understanding for all.
Katherine C. Chretien, MD
Student engagement co-lead, Aquifer, Lebanon, New Hampshire; associate dean for student affairs and professor of medicine, George Washington University School of Medicine & Health Sciences, Washington, DC; firstname.lastname@example.org.
Aparna Krishnan, MD, MPH
First-year family medicine resident, Swedish Medical Center-First Hill, Seattle, Washington.
Molly Rabinowitz, MD, MPH
Second-year pediatric resident, University of California, San Francisco, San Francisco, California.
Production assistant, Aquifer, Lebanon, New Hampshire.
Stephen M. Scott, MD, MPH
Academic director for engagement, Aquifer, Lebanon, New Hampshire; senior associate dean for educational affairs and accreditation and professor of medical education, Texas Christian University and University of North Texas Health Science Center School of Medicine, Fort Worth, Texas.